Cervical facet radiofrequency neurotomy

More than 50% of posttraumatic cervical pain after events such as whiplash is caused by facet joint injury. These patients present with neck pain that often radiates to the head or shoulders and is aggravated by neck movement. Imaging studies are usually negative. If diagnostic local anesthetic blocks of the facet nerves produce appropriate pain relief, then significant and long-lasting pain relief may be obtained by percutaneous cervical facet radiofrequency neurotomy. This outpatient procedure is performed by using fluoroscopy and strictly adhering to proper needle placement. Stimulation is performed before radiofrequency neurotomy to avoid sensory or motor deficits; however, temporary cutaneous dysesthesia and numbness are not uncommon. Success rates range from 60% to 70% with a duration of months to years. The procedure can be repeated if necessary. In addition to pain relief, activities of daily living can be restored, rehabilitation facilitated, and resolution of associated psychological distress can occur. Copyright © 2000 by W.B. Saunders Company